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Health Education Research, Vol. 15, No. 6, 681-694, December 2000
© 2000 Oxford University Press

Cervical cancer and sexual lifestyle: a systematic review of health education interventions targeted at women

Jonathan Shepherd, Greet Peersman1, Ros Weston and Ibrahim Napuli

Health Education Unit, Research and Graduate School of Education, University of Southampton, Southampton S017 1BJ and
1 Centre for the Evaluation of Health Promotion and Social Interventions (The EPI Centre), Social Science Research Unit, Institute of Education, University of London, 18 Woburn Square, London WC1H 0NS, UK

A systematic review was conducted to determine the effectiveness of health education interventions to promote sexual risk reduction behaviours amongst women in order to reduce transmission of human papillomavirus (HPV), a leading agent in the development of cervical cancer. A comprehensive search was conducted to identify relevant studies. Studies were included in the review if they evaluated educational interventions targeting women only and measured the impact on either a behavioural outcome such as condom use for sexual intercourse, partner reduction or abstinence, or a clinical outcome such as incidence of a STD. Thirty studies met the inclusion criteria for the review; all had the primary aim of preventing HIV and other STDs rather than cervical cancer. Ten of the 30 studies were considered to provide the strongest evidence for a causal relationship between the intervention and the change in outcomes measured. Each of these 10 most rigorous studies showed a statistically significant positive effect on sexual risk reduction, typically with increased use of condoms for vaginal intercourse. This positive effect was generally sustained up to 3 months after intervention. It was concluded that educational interventions targeting socially and economically disadvantaged women in which information provision is complemented by sexual negotiation skill development can encourage at least short-term sexual risk reduction behaviour. This effect has the potential to reduce the transmission of HPV and thus possibly reduce the incidence of cervical carcinoma.


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